Provider Demographics
NPI:1922015478
Name:FERNANDEZ, ALBERTO T (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:T
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 W HOUSTON ST STE 409
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2153
Mailing Address - Country:US
Mailing Address - Phone:210-226-9166
Mailing Address - Fax:210-226-9168
Practice Address - Street 1:343 W HOUSTON ST STE 409
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2153
Practice Address - Country:US
Practice Address - Phone:210-226-9166
Practice Address - Fax:210-226-9168
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1848207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB87787Medicare UPIN
TX00R348Medicare ID - Type UnspecifiedMEDICARE ID NUMBER